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Evaluation of Skin Antisepsis Prior to Blood Culture in Neonates

Published online by Cambridge University Press:  02 January 2015

Sylvie Champagne
Affiliation:
Division of Infections Diseases, B.C.'s Children's Hospitaland the Department of Pediatrics, University of British Columbia, Vancouver, Canada
Susan Fussell
Affiliation:
Division of Infections Diseases, B.C.'s Children's Hospitaland the Department of Pediatrics, University of British Columbia, Vancouver, Canada
David Scheifele*
Affiliation:
Division of Infections Diseases, B.C.'s Children's Hospitaland the Department of Pediatrics, University of British Columbia, Vancouver, Canada
*
Division of Infectious Diseases, Department of Pediatrics, B.C.'s Children's Hospital, 4480 Oak Street, Vancouver, British Columbia V6H 3V4

Abstract

In our Intensive Care Nursery, coagulase-negative staphylococcus is the most frequent blood culture isolate. As skin antisepsis is critical in preventing blood culture contamination, we examined the efficacy of the chlorhexidine tincture (CH) used in our nursery for this purpose. Staphylococcus epidermidis colonized the forearms of 88% of infants tested, in a mean density of 104 organisms/cm2. Following a 60-second application of CH (0.5% in 70% ethanol), bacterial growth from forearm skin remained abundant in 15/38 infants (39.4%). Cleansing with 70% isopropyl alcohol, followed by CH as above, left abundant residual growth in only 1/37 infants (2.7%) (P<0.001). All 136 S. epidermidis tested were susceptible to CH (MIC<5(μg/ml) and 14 of 15 exposed to CH 0.02% were rapidly killed (≥98% fall in viable counts within 90 sec). We conclude that two-phase antisepsis using isopropanol followed by CH is a more effective preparation for blood culture in neonates than is CH alone.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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